Sexual Dysfunction

Concerns about sexual functioning are relatively common. In fact, according to one national study, almost half of the women and a third of the men interviewed reported having some kind of concern about their sexual functioning within that last year (Laumann et al., 1999). People can experience problems with their sexual functioning in one or multiple areas. Described below are some common problems that clients bring to me. Problems in these areas can lead to problems in relationships more generally or to negative feelings about yourself.

Desire: Absent or decreased interest in sex/thoughts about sex

Arousal: Arousal is thought to be made up of two parts: what happens mentally, and what happens physically. Mentally, you might feel like you're not 'into it' or not feeling 'turned on' during a sexual encounter. Physically, you might have difficulty getting or keeping an erection (for men) or difficulty getting or staying lubricated (for women) during a sexual encounter. Alternatively, some women have reported a difficulty with persistent physical sexual arousal that won't go away, and it can be embarrassing and extremely frustrating.

Orgasm: It might take a long time to reach orgasm or it might not happen at all after what might be considered adequate sexual stimulation. Or, for men, ejaculation might occur earlier than expected, and you might have difficulty controlling the timing of when it occurs.

Pain: Sometimes people experience pain in their genitals with intercourse, which can be distressing to them and their partners. This pain can be the result of medical issues and/or related to anxiety about sex. For women, this pain might include tension in the pelvic floor muscles making vaginal penetration difficult or even impossible.

The reasons for these problems typically are multiple and complex. Reasons might include a medical condition, medication, aging, relationship issues, family background, feelings about sex, your own mental health, stress, and other life changes that impact your well-being. I will work with you to try to identify the factors contributing to your sexual difficulties in order to find the best approach(es) for treating them. Treatment might involve psychotherapy (individual and/or couples), working with your physician(s), and/or working with a physical therapist (particularly for sexual pain disorders).